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Consensus views on competencies and teaching methods for an interprofessional curriculum on complementary and integrative medicine:A Delphi study

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Journal of Integrative Medicine 2021年第3期19卷 282-290页

作者： Angelika Homberg katja krug Nadja Klafke Katharina Glassen Cornelia Mahler Svetla Loukanova Department of General Practice and Health Services Research University Hospital HeidelbergHeidelberg69120 HeidelbergGermany Department of Nursing Science University Hospital Tübingen72076 TubingenGermany

Objective:A collaborative team is necessary to help patients achieve their healthcare goals using complementary *** present,healthcare professionals do not feel sufficiently qualified to provide this *** study sought to identify competencies and teaching methods for interprofessional training on complementary and integrative medicine at medical ***:Sixty-five German-speaking experts with various professional backgrounds were invited to take part in a three-round Delphi *** the first round,predefined competencies were assessed on a seven-point Likert scale,and participants were invited to propose additional competencies that would be evaluated in the subsequent *** competencies were ranked based on the participant assessments and were assigned to four relevance *** the second and third rounds,suitable teaching methods were identified using free-text fields and multiple-choice *** a final workshop,participants synthesized the outcomes of the previous sessions and derived key competencies that would be a benefit to undergraduate interprofessional training in complementary and integrative medicine at medical ***:The three rounds plus final worksop were attended by 50,40,36 and 11 *** competencies that these experts determined to be highly relevant to teaching complementary and integrative medicine emphasized,in particular,the respectful treatment of patients and the importance of taking a medical *** these highly relevant competencies,three key targets were agreed upon in the final workshop:students are able to 1)classify and assess complementary medical terms and methods;2)work collaboratively and integrate patients into the interprofessional team;3)involve patients and their relatives respectfully and empathetically in all healthcare *** achieve these competency goals,the following teaching methods were highlighted:students discuss therapy options based on authentic patient c

关键词： Undergraduate education Interprofessional education Complementary medicine Delphi study Curriculum Competency

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Hydration status,body composition,and anxiety status in aeronautical military personnel from Spain:a crosss-ectional study

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Military Medical Research 2022年第2期9卷 184-192页

作者： Alejandra Carretero-krug Nataliaúbeda Carlos Velasco Juan Medina-Font Trinidad Trujillo Laguna Gregorio Varela-Moreiras Ana Montero Departamento Ciencias Farmacéuticas y de la Salud Facultad de FarmaciaUniversidad San Pablo-CEUCEU UniversitiesUrbanización Montepríncipe28660 Boadilla del MonteSpain Centro de Instrucción de Medicina Aeroespacial Ejército del Aire28850 Torrejón de ArdozMadridSpain

Background: An adequate hydration status is critical to ensure efficiency during mental and physical *** goal was to assess the hydration status of a Spanish group of aeronautical military men and to determine the association of hydration status with body composition and ***: A total of 188 men were evaluated through a validated hydration questionnaire, anthropometric and biochemical parameters, and an anxiety questionnaire. Based on these methods, the criteria of hydration were ***: Of the total sample, 81% met the hydration criteria(urine color = well hydrated, water balance ≥0 ml, and total water intake/weight ≥35 ml/kg), and 19% did not meet the hydration criteria(urine color = not sufficiently hydrated or dehydrated, water balance <0 ml, and total water intake/weight <35 ml/kg). Subjects not meeting the hydration criteria had lower urine pH, negative water balance, and lower water intake. The latter also had higher anxiety status(score=4 vs. 3, P=0.026), weight [(84.7±10.5) kg vs.(80.5±10.2) kg], body mass index [(26.3±3.1) kg/m;vs.(25.2±2.8) kg/m;], body fat [(22.3±5.6)% vs.(18.3±6.5)%], urine specific gravity, and urine color. Using a logistic binary regression model, hydration status was related significantly with the percentage of body fat(P=0.004), but no relation was found with age, comorbidities, or medications. Furthermore, total water intake/weight was positively correlated with percentage of body water(r=0.357, P=0.000) and negatively with body fat(kg)(r=–0.427, P=0.000), percentage of body fat(r=–0.405, P=0.000), and waist/hip ratio(r=–0.223, P=0.002). Based on a linear regression model, total water intake/weight was related significantly with percentage of body fat(P=0.001) and percentage of body water content(P=0.035). No relation was found, however, with waist/hip ratio, age, comorbidities, or ***: These findings all suggest a relationship between hydration status and body composition but

关键词： Hydration status Military aeronautical personnel Body composition Anxiety status Water intake

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Hypoxic pre-conditioned adipose-derived stem/progenitor cells embedded in fibrin conduits promote peripheral nerve regeneration in a sciatic nerve graft model

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Neural Regeneration Research 2023年第3期18卷 652-656页

作者： Julius M.Mayer Christian krug Maximilian M.Saller Annette Feuchtinger Riccardo E.Giunta Elias Volkmer Thomas Holzbach Department of Hand-and Plastic Surgery Spital ThurgauFrauenfeldSwitzerland Musculoskeletal University Center Munich(MUM) Department of Orthopedics and Trauma SurgeryLudwig-Maximilians-University(LMU)Planegg-MartinsriedGermany Research Unit Analytical Pathology MunichHelmholtz Zentrum München-German Research Center for Environmental Health(GmbH)NeuherbergGermany Division of Hand- Plastic-and Aesthetic SurgeryLudwig-Maximilians-University(LMU)MunichGermany Division of Hand Surgery Helios Klinikum München WestMunichGermany

Recent results emphasize the supportive effects of adipose-derived multipotent stem/progenitor cells(ADSPCs)in peripheral nerve *** under hypoxia is considered to enhance the release of the regenerative potential of *** study aimed to examine whether peripheral nerve regeneration in a rat model of autologous sciatic nerve graft benefits from an additional custom-made fibrin conduit seeded with hypoxic pre-conditioned(2%oxygen for 72 hours)autologous ADSPCs(n=9).This treatment mode was compared with three others:fibrin conduit seeded with ADSPCs cultivated under normoxic conditions(n=9);non-cell-carrying conduit(n=9);and nerve autograft only(n=9).A 16-week follow-up included functional testing(sciatic functional index and static sciatic index)as well as postmortem muscle mass analyses and morphometric nerve evaluations(histology,g-ratio,axon density,and diameter).At 8 weeks,the hypoxic pre-conditioned group achieved significantly higher sciatic functional index/static sciatic index scores than the other three groups,indicating faster functional ***,histologic evaluation showed significantly increased axon outgrowth/branching,axon density,remyelination,and a reduced relative connective tissue *** pre-conditioned ADSPCs seeded in fibrin conduits are a promising adjunct to current nerve *** studies are needed to understand the underlying cellular mechanism and to investigate a potential application in clinical practice.

关键词： adipose-derived progenitor cells adipose-derived multipotent stem/progenitor cell autologous nerve graft fibrin conduit hypoxia hypoxic pre-conditioning nerve defect nerve tissue engineering peripheral nerve regeneration regenerative medicine

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Tree water potentials supporting an explanation for the occurrence of Vachellia erioloba in the Namib Desert (Namibia)

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Forest Ecosystems 2017年第4期4卷 303-312页

作者： Joachim H. A. krug Institute for Silviculture and Forest Ecology Georg-August-University of Gottingen Bosgenweg 1 37077 Gottingen Germany

Background： Site-vegetation relations of Vachellia erioloba, Faidherbia albido, Euclea pseudebenus and Tamarix usneoides in two contrasting locations in the Namib Desert （Namibia） were evaluated with the goal to relate soil water availability to the occurrence of trees under hyper-arid conditions, Methods： Plant water potentials were measured using a pressure chamber in the field. Pre-dawn water potentials were assessed to reflect the soil water potential of the rhizosphere. Midday water potentials were measured to assess the strongest negative water potential applied by the sample trees. Results： Pre-dawn water potentials and midday water potentials indicated access to soil water in the rhizosphere and by this, provide an explanation for an occurrence of V. erioloba within the extreme environmental conditions of sand dunes in the Namib Desert. Diurnal ranges seem to reflect more and less suitable stands, in terms of soil water availability, within the sampling sites. While the impact of the ephemeral Kuiseb river on soil water availability was assessed through the four species＇ plant-internal water relations, comparable pre-dawn water potentials of V. erioioba at both sites indicate soil water availability also in the dunes of Namibrand. The extreme midday water potentials of the dune plants possibly show the upper limit of tolerance for V. eriolobo. Conclusions： The preliminary data provide an explanation of the occurrence and distribution of the investigated species in beds of ephemeral rivers and on dunes under the hyper-arid climatic conditions of the Namib Desert and qualify suitability within the assessed sites. Understanding the plant-physiological processes and assessing the plant-internal water potential provides a valuable tool to evaluate soil water availability within the rhizosphere and to describe an adaptation potential of investigated species. The comparability of pre-dawn water potentials at both sites indicates unexpected soil water availability w

关键词： Water potential Arid land Soil water availability Namibia V. erioloba

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Radiological Imaging in Patients with Esophageal Carcinoma

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The Chinese-German Journal of Clinical Oncology 2004年第4期3卷 215-218页

作者： Barbara krug Claudia Morgenroth Department of Radiology University of CologneDepartment of Radiology University of Cologne Cologne GermanyCologne Germany

Diagnostic imaging is carried out in patients with esophageal carcinoma in order to decide on the therapeutical procedure, to control therapy, to document complications and to assess concomitant diseases. Chest X-rays and esophagograms give a 2-dimensional view of the X-ray absorption in 3-dimensional examination volumes, the diagnostic accuracy thus being limited by overshadowing. Because of the robust examination technique, the broad availability and the low costs chest X-rays are usually used for short-term controls under therapy and follow-up. Esophagography is carried out in order to asses the exact location and length of a known esophageal carcinoma prior to therapy and in order to assess peristaltic disturbances and ?stulas. CT and MRI provide tomographic images with a spatial resolution of up to 1 mm3 allowing the reconstruction of high-resolution images not only in the transversal but also in any other plain. The diagnostic accuracy of esophagography is comparatively high in T1–T3 stages (80%–90%). T1 and T2 tumors cannot be diagnosed by CT and MRI, because both methods do not visualize the mucosa (unlike esophagography and endoscopy) and the esophageal wall layers (unlike EUS). In?ltration depth tends to be overestimated in T1 and T2 carcinomas and to be underestimated in T3 and T4 cancers. CT and MRI cannot detect metastases in normally sized lymph nodes and cannot accurately di?erentiate between benign and malignant lymphadenopathy in enlarged nodes with a reported sensitivities and speci?ties of 60% and 74%, respectively. However, further prospective studies using up to date CT and MR technology are needed to assess the present diagnostic situation. CT and MRI do not only visualize the mediastinum, but also the lungs, the pleura and the skeleton as well as the neck and the abdomen thus providing a comprehensive overview of the TNM stage in 3 body regions.

关键词：食管癌影像学纵隔病理学段层摄影 X线计算肿瘤

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GA-based nonlinear predictive switching control for a boiler-turbine system

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控制理论与应用（英文版） 2012年第1期10卷 100-106页

作者： Jie WU Jiong SHEN Mattias krug Sing Kiong NGUANG Yiguo LI School of Energy and Environment Southeast University Nanjing Jiangsu 210096 China Department of Electrical and Computer Engineering The University of Auckland Private Bag 92019 Auckland 1142 New Zealand

In this paper, the problem of designing a controller for a highly coupled constrained nonlinear boiler- turbine system is addressed with a predictive controller. First, a nonlinear predictive control is implemented by genetic algorithm. Second, to guarantee fast output stabilization, an H-infinity fuzzy state-feedback tracking control is applied with a designed switching principle. The success of such a control structure is based on taking advantage of the optimal input sequence derived from the nonlinear predictive control based on artificial intelligent while ensuring a fast decay of the steady state error. Simulation results of the proposed design are given to illustrate its effectiveness and compared to other control schemes.

关键词： Genetic algorithm (GA) Nonlinear receding horizon control Adaptive control Boiler-turbine Switching control

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Treatment of unresectable malignant pleural mesothelioma in 2021: emerging standards in immunotherapy

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Journal of Cancer Metastasis and Treatment 2021年第1期7卷 737-747页

作者： Bailey G.Fitzgerald Lee M.krug Tisch Cancer Institute Icahn School of Medicine at Mount SinaiNew YorkNY 10029USA AstraZeneca GaithersburgMD 20878USA

Patients with unresectable malignant pleural mesothelioma(MPM)have historically poor outcomes and treatment,and their treatments have been limited to palliative *** efforts to improve prognosis for these patients by adding angiogenesis inhibitors to chemotherapy led to significant ***,the emergence of immunotherapy combinations for the front-line treatment has upended the standard of care and has led to the first new FDA approvals for the treatment of MPM in nearly two *** review aims to cover the main clinical trials in unresectable MPM with VEGF inhibitors and immunotherapy which have led to paradigm shifts in current *** clinical trials exploring the combination of chemo and immunotherapies show a great deal of promise,and continued support for ambitious,large-scale well-designed trials remain vital for defining the future outcomes of patients diagnosed with MPM.

关键词： Malignant pleural mesothelioma VEGF chemotherapy immunotherapy PD-L1 CTLA-4

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Morphological and molecular diversity of arbuscular mycorrhizal fungi in revegetated iron-mining site has the same magnitude of adjacent pristine ecosystems

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Journal of Environmental Sciences 2018年第5期30卷 330-343页

作者： Caroline krug Vieira Matheus Nicoletti Marascalchi Arthur Vinicius Rodrigues Rafael Dutra de Armas Sidney Luiz Stürmer Universidade Regional de Blumenau(FURB) Programa de Pos-Graduacao em Engenharia Ambiental89030-903 BlumenauSCBrazil Universidade Regional de Blumenau(FURB) Departamento de Ciencias Naturais(DCN)89030-903 BlumenauSCBrazil Uniuersidade Regional de Blumenau(FURB) Programaa de Pos-Graduacao em Engenharia Florestal89030-903 BlumenauSCBrazil Centro Universitario-Catolica de Santa Catarina 89203-005 JoinvilleSCBrazil

Arbuscular mycorrhizal fungi（AMF） are important during revegetation of mining sites, but few studies compared AMF community in revegetated sites with pristine adjacent ecosystems. The aim of this study was to assess AMF species richness in a revegetated iron-mining site and adjacent ecosystems and to relate AMF occurrence to soil chemical parameters. Soil samples were collected in dry and rainy seasons in a revegetated iron-mining site（RA） and compared with pristine ecosystems of forest（FL）, canga（NG）,and Cerrado（CE）. AMF species were identified by spore morphology from field and trap cultures and by LSU r DNA sequencing using Illumina. A total of 62 AMF species were recovered, pertaining to 18 genera and nine families of Glomeromycota. The largest number of species and families were detected in RA, and Acaulospora mellea and Glomus sp1 were the most frequent species. Species belonging to Glomeraceae and Acaulosporaceae accounted for 42%–48% of total species richness. Total number of spores and mycorrhizal inoculum potential tended to be higher in the dry than in the rainy season, except in RA. Sequences of uncultured Glomerales were dominant in all sites and seasons and five species were detected exclusively by DNA-based identification. Redundancy analysis evidenced soil p H,organic matter, aluminum, and iron as main factors influencing AMF presence. In conclusion, revegetation of the iron-mining site seems to be effective in maintaining a diverse AMF community and different approaches are complementary to reveal AMF species, despite the larger number of species being identified by traditional identification of field spores.

关键词： Community structure Glomeromycota Illumina LSU rDNA Spore morphology Taxonomic distinctness index

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Validation of a novel animal model for sciatic nerve repair with an adipose-derived stem cell loaded fibrin conduit

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Neural Regeneration Research 2018年第5期13卷 854-861页

作者： Maximilian M.Saller Rosa-Eva Huettl Julius M.Mayer Annette Feuchtinger Christian krug Thomas Holzbach Elias Volkmer Experimental Surgery and Regenerative Medicine (ExperiMed) Department of General Trauma and Reconstructive SurgeryLudwig-Maximilians-University (LMU) Max-Planck-Institute of Psychiatry Department of Stress Neurobiology and Neurogenetics Department of Hand- Plastic-and Aesthetic Surgery Ludwig-Maximilians-University (LMU) Research Unit Analytical Pathology Munich Helmholtz Zentrum Muenchen-German Research Center for Environmental Health (GmbH) Department of Hand and Plastic Surgery Spital Thurgau AG

Despite the regenerative capabilities of peripheral nerves, severe injuries or neuronal trauma of critical size impose immense hurdles for proper restoration of neuro-muscular circuitry. Autologous nerve grafts improve re-establishment of connectivity, but also comprise substantial donor site morbidity. We developed a rat model which allows the testing of different cell applications, i.e., mesenchymal stem cells, to improve nerve regeneration in vivo. To mimic inaccurate alignment of autologous nerve grafts with the injured nerve, a 20 mm portion of the sciatic nerve was excised, and sutured back in place in reversed direction. To validate the feasibility of our novel model, a fibrin gel conduit containing autologous undifferentiated adipose-derived stem cells was applied around the coaptation sites and compared to autologous nerve grafts. After evaluating sciatic nerve function for 16 weeks postoperatively, animals were sacrificed, and gastrocnemius muscle weight was determined along with morphological parameters（g-ratio, axon density ＆ diameter） of regenerating axons. Interestingly, the addition of undifferentiated adipose-derived stem cells resulted in a significantly improved re-myelination, axon ingrowth and functional outcome, when compared to animals without a cell seeded conduit. The presented model thus displays several intriguing features： it imitates a certain mismatch in size, distribution and orientation of axons within the nerve coaptation site. The fibrin conduit itself allows for an easy application of cells and, as a true critical-size defect model, any observed improvement relates directly to the performed intervention. Since fibrin and adipose-derived stem cells have been approved for human applications, the technique can theoretically be performed on humans. Thus, we suggest that the model is a powerful tool to investigate cell mediated assistance of peripheral nerve regeneration.

关键词： critical-size nerve defect fibrin conduit autologous nerve transplant peripheral nerve regeneration adipose-derived stem/progenitor cells sciatic function index sciatic nerve re-innervation axon guidance peripheral circuitry

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The Danube, an Empire Boundary River: Settlements, Invasions, Navigation, and Trade Pathway

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Journal of Water Resource and Protection 2020年第10期12卷 884-897页

作者： Kenneth R. Olson Edward krug Department of Natural Resources and Environmental Sciences College of Agricultural Consumer and Environmental Sciences University of Illinois Urbana USA Illinois State Water Survey Champaign USA

The Danube River basin was home to some of the world’s earliest human cultures such as the Danubian Neolithic cultures including the Linear Pottery culture. The Vucedol culture was famous for ceramics during the third millennium BC. Early settlement required fortresses and castles to be built on the Danube River to defend the settlements from invading forces. These included the Persia, Roman and Ottoman empires. Cities included Vienna, Budapest, Belgrade and Ruse. The risks include stream capture, settlement, invasions, navigation, trade, pollution, industrial and urban wastewater, over fishing, food insecurity, locks and dams, shoreline erosion and flooding. The primary objective was to document the settlement history on the Danube River which became Eastern Europe’s pathway for settlement, invasions, navigation and trade in the Danube basin has put the river at risk for more than 2500 years. River capturing of the Danube by the Rhine River has reduced the length and flow of the Danube. The Danube River has had a huge economic, social and environmental impact on 10 European countries. However, with 10 countries sharing the river it has been difficult to manage and mitigate the risks and threats to the Danube River and its water quality.

关键词： Locks Dams Flooding Shoreline Erosion Fishing Drinking Water Ottoman Roman Hydroelectric Pirate Attacks

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